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Wednesday, December 2, 2015

Taking a Mental Health Break from My Dissertation

Today's guest post is by Nicole Cabrera Salazar. Nicole is an NSF Graduate Research Fellow at Georgia State University. She plans to pursue a career in science communication/outreach focusing on equity in STEM.

About a month ago, I got sick with a simple cold. I was in the middle of writing the third chapter of my dissertation and had just taken time off to get over another cold two weeks before. I was also behind on the timeline to defend my thesis next year, and more delays didn’t seem like the best idea. So I did what any other grad student in my position would: I tried to power through.

Ten days later, my cold was still going strong. I was worried because I had been waking up with panic attacks in the middle of the night for no apparent reason, hyperventilating and shaking uncontrollably. Sick, sleep deprived, and anxious, I gave in and went to the doctor. I burst into tears as soon as she came into the room.

The doctor calmed me down and tested for signs of a bacterial infection. Nothing. “It’s just a viral cold,” she said. It wasn’t going away because the anxiety was preventing me from sleeping, which prevented me from getting better. She asked what was causing so much stress and gave me a sympathetic look when I said I was writing my dissertation. “Go home and just watch a movie. Don’t try to work. It’s really okay.”

With the doctor’s blessing, I took a few days off. The sleep aid she prescribed helped me sleep through the night and I was certain I would quickly get better. But even though the cold symptoms slowly started to wane, my anxiety did not. I constantly felt as if my heart was being squeezed and breathing felt like I had a stack of books on my chest. Imagine the rollercoaster, butterflies-in-your-stomach jitters you might get before a big talk or an interview, but stretched out over days.

When I realized the anxiety wasn’t going away on its own, I began to seriously worry about my mental health. I remember waking up one night after another panic attack and being afraid that if I didn’t do something soon, I was going to have a nervous breakdown. I worked up the courage to tell my adviser exactly what was happening, scared to admit it but knowing I had no other choice. Although it was hard to get the words out, my adviser was patient and sympathetic. He agreed that my mental health took priority over my work and told me not to worry about deadlines. He granted me a three week break from research, and I resolved to stop thinking about my dissertation and stay off campus as much as possible.

At my follow-up appointment that week, I told the doctor about the anxiety I was still feeling. She knew I was already seeing a therapist weekly, had stopped working, and was focusing my energy on getting better. After a long discussion, she recommended I start taking a selective serotonin re-uptake inhibitor (SSRI). “When you’re doing everything right and the anxiety is still there, it may be time to change the chemistry.”

Since the dissertation seemed to be my biggest trigger, she suggested that I keep taking SSRIs until after I finished my PhD -- at least a year away. It was a scary decision to make because I had never been on medication. What if it changed my personality? What about the side effects? She answered all my questions and assured me that I would be checking in every few weeks to see how it was affecting me. If it didn’t work or if the side effects were intolerable, we could always adjust the dosage or even the type of SSRI.

Still, medication is only one part of the equation. In my time away from research, I’ve been working on projects that I love but don’t bring more stress, things like mentoring and the long-overdue process of updating my CV. I’ve also set aside time for self-care, which in my case involves cooking and eating regular meals, working on crafts, spending time with friends and family, and reading about things not related to astronomy. And very slowly, I am starting to feel better.

I am following this emergency self-care plan out of sheer necessity. Most of us make this mistake, turning to self-care for survival in a crisis. In reality, self-care should be a daily practice that prevents us from needing this sort of intervention. I thought that taking time away from work would delay my progress, but ironically I’ve lost much more time because I did not take proper care of myself first. I’m learning this the hard way, but I hope that my experience will serve as a gentle reminder to myself and others to prioritize health over work. As Drs. Sarah Ballard and Rugheimer point out in their podcast, self-care is part of the job. I cannot do my best scientific work if I am stressed, unhappy, or burned out.

When I do feel okay enough to get back to work, I’m going to have to pace myself. Yes, I want that PhD more than anything. No, it is not worth my physical or mental health to race there. I’ll have to remember that I deserve to sleep enough, eat at regular intervals, and constrain my work to daytime hours so I can recharge when I get home. I’ll have to reward myself for small accomplishments like writing a section or getting all my citations in order. I’ll have to be mindful not to withdraw from my loved ones when I get overwhelmed. Otherwise, the incremental path toward success will be too bleak.

6 comments
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I recognize your story so much. I had the same when I was doing my master thesis and had the most uninteresting results. I felt terrible (arrythmia, anxiety, nervousness) and had a deep depression. Long hours, long days...and it did not lead to anything but disappointment. It took me 3 times as long to finish the master thesis as was originally intended. People whispered behind my back "whats wrong with that girl?".

Against all odds to be admitted with terrible recommendations, I decided to go for a 5-years PhD. The reason was that I really wanted to understand the phenomenology of the lovely objects I worked with. I had failed so far. This time I decided only to do what I myself am interested in.

Three full years have passed and this is my average work day:

-i go up at 9 am and do my hobbies in the morning.-at 12 i go to work. it starts with a 1 hour lunch.-then I work with what i feel is most interesting this day. It often includes another 45 minutes of coffee drinking, and some emailing.-at 6 pm i go home and eat (and prepare) a nice dinner.-then i spend the evening watching crappy movies or talking to friends or doing some other hobbies, like responding to this blog :)

One may think that this could lead to disaster. But no -- I feel relaxed, enjoying the PhD entirely. Not anxious anymore, calm, relaxed, always having time for things I like. And so far I've been very lucky with publications...so far.

With this, I learned the following lessons:

(1) *Set limits*. Your research, you decide. If people don't agree with you, just let them drop out of the coauthor list. After all, you know better what you are doing than somebody you discuss your work with. Be aware of that some people (often guys) want to impose their ideas on younger women and try to convince you into that you are wrong and they are right. So ignore useless comments.

(2) There is no obligation to anything or anybody. There is nobody to please. Beware of the "good girl"-syndrome and avoid it at all costs. Your obligation is to have fun and enjoy the research itself to the maximum. "What do I want to find out today?"

(3) Do varied activities that stimulate different parts of the brain every day.

(4) Don't do research to impress. Do research to find out the answer to the question you mostly want to know.

i ended up taking 4 years between my viva and finally submitting minor corrections (just recently completed), after a years-long build-up of ignored mental health issues. i'm a far happier person now but i do worry that the very large gap in my academic timeline will cause issues with regard to progressing with my career.

Excellent post and a very familiar story. I had a similar "break" last year and have been slooowly getting better (also with SSRIs) ever since. I've had two first-author publications (and more as co), but am still not at the pace I once was. I try to tell myself that this is okay, but my adviser -- as generous and understanding as he has been -- happened to say during a recent meeting that "it's been plenty of time" and I "should be better by now". That was discouraging, to say the least.

I also really want to thank the commenter Mia, above: thank you so very much for posting your daily routine!! It's very similar to mine, but I keep having that nagging voice in my head saying how I'm not working nearly enough. Plus the occasional comment from others that I'm "slacking" now. I agree: if I feel better with a more relaxed schedule and improve the quality of my work, my 9-5 routine shouldn't matter. I feel better reading your comment, thank you!

I had similar issues in the PhD (and after!). I tried counseling but we only had free sessions at the school for about once every two weeks for a few months. It was too expensive (money and time wise) for me to seek more help. I was too anxious and depressed to talk with my advisor about the problem. I ended up working from home for a month one November the year before I defended. My advisor never asked or said anything until much later. When I told him I wanted to defend that summer, he brought up that he didn't know if I'd be able to make that timeline because I hadn't worked much that January (shows how much some advisors pay attention! he got the month wrong and I had been working, just not in the office). For me, I continue to power through even after and found it too difficult to confront my advisor about my personal problems. I think a lot of advisors don't want to have these conversations, as they are uncomfortable and not in their job description. It is so brave of you, Nicole and Mia, to openly discuss these problems! I bet that they are far more common, but most of us suffer in silence.